Have your own general practitioner and see him/her regularly (at least annually).(Resource Document 09). Choose a GP who is used to dealing with doctors as patients. Allow yourself to be a patient, and ensure your doctor treats you as one. How would you shape up as an anaesthetic risk? Dental and ophthalmic care are necessary too.

Do not self-diagnose or self-medicate (especially with sedatives). Corridor consultations are to be avoided.

Reassess your diet, alcohol and tobacco intake regularly.

Have breakfast every day.Take a lunch break outside the operating theatre.

Do not be manipulated into undertaking a whole day solo list without any breaks.

Remember the benefits of regular exercise. Re-discover the joys of music, books, art, conversation and relationships.

Recognise yourself as an expert on a par with any of your colleagues.

Take sick leave when it is necessary.Take all leave due to you. Do not be manipulated into feeling a break is impossible.

Take stock of your life once a year: Am I happy? Do I like my lists/surgeons? Who/what is stressing me? What can I do about it?

RD13. Impairment in a Colleague

An impaired practitioner is one who is suffering from any physical or mental condition which affects or has the potential to affect, his or her capacity to practice medicine safely. It may be acute, episodic or chronic.

The medical profession has a duty of care to the profession as well as patients – there is a duty to report an impaired colleague to the relevant medical board if patient safety is jeopardised. This is mandatory in some States/New Zealand. Most State Medical Boards and the Medical Council of New Zealand have Impaired Registrant panels which can advise on, and supervise treatment and rehabilitation of, doctors with performance issues in a structured, supportive, non-punitive manner.

In the case of drug dependency, see Resource Document 02 and the Auckland Hospital Substance Misuse Protocol.

If necessary, trusted colleagues or nursing staff should be specifically asked to monitor performance, in complete confidence. Potential medico-legal problems must be considered. Consult with your defence organisation. Privacy issues should also be considered. All concerns must be documented.

Discussion of the problems with the person concerned should be done with extreme care, The person should have a support person accompanying him/her if they wish. Insight should be assessed. Take time to listen.

Sick leave, retraining or retirement options must be considered. ANZCA can assist with competency assessment.

Anaesthetists should not self-diagnose or self-medicate. Corridor consultations should be discouraged. The importance of having one’s own general practitioner is again emphasised.

References

Medical Board of South Australia The Need for Care of the Medical Profession 2003

Atkinson RS The problem of the unsafe anaesthetist BJA 1994 73:29-30

O’Hagan J. The best of health to you, doctor. NZMJ 1996 109:280-2

Posen S. Doctors in Literature. The portrayal of the doctor in non-medical literature: the impaired doctor. MJA 1997 166:48-51

NB: The 3 Resource Documents listed above have been prepared in good faith and having regard to general circumstances and is intended for information only. It is entirely the responsibility of the practitioner as to the manner in which s/he follows these documents, having express regard to the circumstances of each case, and in the application of these documents in each case.

The information contained in these document is not intended to constitute specific medical or other professional advice. The College and Societies, their officers and employees, take no responsibility in relation to the application of use of these Resource Documents in any particular circumstance.

These Resource Documents have been prepared having regard to the information available at the time of their preparation. They are reviewed from time to time, and it is the responsibility of the practitioner to ensure that s/he has obtained the current version. The practitioner should therefore have regard to any information, research or material which may have been published or become available subsequently.

Whilst the Welfare of Anaesthetists Special Interest Group endeavours to ensure that Resource Documents are as current as possible at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material which may become available subsequently.